共查询到20条相似文献,搜索用时 68 毫秒
1.
2.
酷似心内膜下心肌梗死的心尖部肥厚性心肌病 总被引:1,自引:0,他引:1
酷似心内膜下心肌梗死的心尖部肥厚性心肌病周军荣,卢喜烈,阎保国患者,男性,40岁。二月前以急性心内膜下心肌梗死在当地医院就诊治疗。因活动后气急,乏力9个月于1993年12月26日再次入院。既往高血压病史20年,血压高达21/13Kpa。查体:心界向左... 相似文献
3.
1 临床资料 例1,患者男性,43岁,本院B超医师,4个月前因上颌窦手术住院,常规心电图显示ST-T明显异常。无糖尿病、高血压、高脂血症病史,无心脏病家族史。体检:血压 130/80mmHg(1mnHg=0.133kPa),颈静脉未见怒张,双肺清晰,心界不大,心率74次/min,心律齐,未闻见病理性杂音,双下 相似文献
4.
患者男性 ,40岁。因胸闷1年 ,加重3天入院。曾诊断为冠心病。体检 :BP110/70mmHg,心界不大 ,心尖搏动强有力 ,心率68次/min ,心律齐 ,心尖区可闻及Ⅱ级收缩期杂音及第3心音。肝脾无肿大。X线胸片及血清心肌酶检查正常。心电图 (图1)示 :窦性心律 ,心率60次/min ,P_R间期0.14s ,QRS时间0.08s ,QRS波群在Ⅱ导联呈R型 ,V5 导联呈RS型 ,V6 导联呈Rs型 ,没有Q波 ,而V1、2 导联呈QS型 ,没有r波 ,V4~6ST段压低>0.05mV ,T波I、aVL浅倒 ,V3~6 深尖倒置 ,V… 相似文献
5.
患者女性,42岁。于1998年体查时,临床依据心电图提示“慢性冠状动脉供血不足”而诊断为冠心病,并对症治疗。此间患者无明显的不适感觉,既往亦无高血压病史。从2001年12月开始患者自觉胸闷、心悸、气短、尤其在活动或劳累后明显。因胸闷、气短加重1W入院。体格检查:血压130/80mmHg,神志清,口唇无紫绀,无颈静脉怒张,心率72 相似文献
6.
心尖肥厚型心肌病是原发性肥厚型心肌病的一个亚型 ,临床上较少见。我科自 1998年以来收治本病 4例 ,现择其中3例分析心电图表现如下。例 1:患者男 ,46岁 ,因胸闷 3年 ,加重 3天入院。曾诊断冠心病。心电图 :窦性心律 ,心率 68次 / min,P- R间期 0 .16s,QRS时间 0 .0 8s,V1 导联 r S型 ,V5导联 Rs型 ,没有 q波 ,RV4高 2 .5 m V,RV5+ SV1 =3 .7m V。 I、a VL、V4- 6 ST段压低0 .0 5~ 0 .10 m V,T 波 I、a VL、V3- 6 倒置 ,V4倒置最深达0 .7m V,Q - T间期 0 .46s。 X线胸片及血清心肌酶检查正常。心电图诊断 :窦性心律 ,心肌缺… 相似文献
7.
心尖肥厚型心肌病是主要累及心尖部的变异型心肌病,多见于日本,故又称“日本心肌病”。而在我国较少见,约占肥厚型心肌病2%~5%左右,因其有特殊的心电图特征,近年来日益引起有关人士的重视。现分析所见7例心尖肥厚型心肌病的心电图特征,以提高心电图对此病的诊断。 相似文献
8.
心尖肥厚型心肌病 (AHCM)属原发性心肌病的 1种特殊类型 ,因其特殊的心电图特征 ,日益引起人们关注。本文报告 5例于后。男 4例 ,女 1例 ,年龄 2 1~ 47(平均3 4 5 )岁 ,病程 6月~ 6年 ,临床症状各异 ,病程短者可无明显症状 ,仅在健康查体时发现 ( 2例 )。随病程延长可有活动后胸闷、气短等 ,无高血压及心绞痛病史。均经二维超声心动图 (UCG)确诊。UCG显示 :心尖部局限性心肌肥厚 19~3 0mm ,无左室流出道狭窄 ,无瓣膜病变 ,房室各腔大小正常。 2例给予冠脉造影显示冠脉无狭窄。心电图表现为 ①左胸导联R波振幅增高 :5例左胸… 相似文献
9.
50例心尖肥厚型心肌病患者心电图特点分析 总被引:1,自引:0,他引:1
对2002~2006年确诊的50例心尖肥厚型心肌病(AHCM)患者的心电图进行回顾性分析,结果发现50例患者均有左胸导联T波倒置及ST段压低,呈典型的Tv4>Tv5>Tv3者30例,左胸导联R波电压增高44例,Rv4>Rv5>Rv6者35例.认为胸前导联T波倒置伴R波振幅增高为AHCM的特征性心电图表现,临床应注意与冠心病、心肌梗死等鉴别. 相似文献
10.
心尖肥厚型心肌病四例心电图误诊分析 总被引:1,自引:0,他引:1
心尖肥厚型心肌病在心电图上呈胸前导联巨大T波倒置,高QRS波,同时伴ST段下降,酷似心肌缺血或心内膜下心肌梗塞的心电图改变[1]。加之患者刚好处于冠心病的发病年龄段,临床上往往被误诊断为“冠状动脉硬化性心脏病”甚至“前壁心内膜下心肌梗塞”[2]。我院... 相似文献
11.
Miyoshi S Hara Y Ogimoto A Shigematsu Y Okura T Higaki J 《Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics》2005,42(1):112-115
A 67-year-old woman had been examined due to abnormalities on electrocardiography (ECG) at a medical checkup three years previously. When a negative T-wave was seen in leads I, aVL, and V1 to V4, but the abnormal findings were improved at consultation. Echocardiography revealed apical hypertrophy and hypertrophic nonobstructive cardiomyopathy was diagnosed. She felt chest discomfort in September, 2003 and an ECG showed a negative T-wave in leads I, II, III aVL, aVF and V2 to V6 and an elongation of QT interval Left ventriculography revealed myocardial hypertrophy at the left ventricular apex and left ventriclar wall motion was normal. Coronary angiography did not show any significant luminal narrowing. I-123 metaiodobenzyl-guanitidine scintigraphy showed marked perfusion defects at the left ventricular apex. After five months, ECG showed an improvement of the QT interval and a decrease in the negative T-wave. We considered that the repeated changes of ECG were caused by Takotsubo-type cardiomyopathy. 相似文献
12.
Electrocardiographic criteria of right ventricular hypertrophy were found in a 17-year-old male with nonobstructive hypertrophic cardiomyopathy involving the left ventricle. Right ventricular hypertrophy pattern is a rare electrocardiographic abnormality in patients with hypertrophic cardiomyopathy and the presence of Q waves in leads V5-V6 could be helpful in differentiating this syndrome from true right ventricular hypertrophy. 相似文献
13.
14.
目的 探讨肥厚型心肌病(HCM)患者体表心电图(ECG)特征。 方法 选取2015年5月~2017年4月期间住院治疗的HCM患者60例,同时选取本院同期查体的正常人60例,作为对照组,要求两组人员性别、年龄、体质量指数匹配。分析ECG各导联QRS波时限和R波、S波振幅,异常q波情况,QTC时限,R/S比值, ST段下移与抬高,T波低平、倒置,P波时限等指标。 结果 ①HCM组的V2、V3导联QRS波时限;Ⅱ、V4导联异常Q波比例;QTC时限;P波时限;左心室肥厚ECG诊断公式SV1+RV5/V6及(SV3+RaVL)×QRS波时限均显著高于正常对照组。②HCM组的I、aVR、aVL、aVF导联QRS波时限;aVR导联Q波所占比例; I、Ⅱ、Ⅲ、aVL、aVF、V3、V4、V5、V6导联QRS波主波与T波方向一致性; V4、V5、V6导联R/S比值均显著低于正常对照组。 结论 ECG诊断HCM首先要满足左心室肥厚的诊断标准,再结合上述ECG导联的特异性参数进行综合判断。 相似文献
15.
目的探讨肥厚型心肌病住院患者的心电图特点。方法对1994年5月~2005年7月北京大学人民医院和北京世纪坛医院收治的经超声心动图诊断为肥厚型心肌病的住院患者76例,分析其心电图特点。结果按肥厚的部位分为单纯室间隔肥厚或室间隔肥厚为主组(46例)、单纯心尖肥厚组(14例)、单纯游离壁肥厚组(6例)和弥漫性肥厚组(10例)。间隔肥厚为主组患者中,23例(50.0%)存在病理性Q波,其中间隔厚度超过2.0cm者10例(42.5%);而在另23例无病理性Q波患者,间隔厚度超过2.0cm者仅5例(21.7%)。心尖肥厚组和单纯游离壁肥厚组均仅1例心电图存在病理性Q波。QRS波群宽度在各组无显著性差异(p>0.05)。76例患者中,心电图符合左室肥厚(SV1 RV5≥4.0mV)诊断标准的23例(30.3%),符合RV4>RV5>RV6(或RV3>RV4>RV5)者34例(44.7%),ST-T改变共71例(93.4%),ST段下移超过0.1mV者53例(69.7%),T波深倒置振幅超过0.5mV者30例(39.5%)。T波深倒置在心尖肥厚组多于间隔肥厚组(P=0.02),但T波倒置深度与心尖肥厚程度无明显相关(p=0.40)。间隔肥厚为主组中梗阻型和非梗阻型各项心电图指标无显著性差异(p>0.05)。结论病理性Q波多出现在室间隔肥厚为主型患者,T波深倒置在心尖肥厚组多于间隔肥厚组,但T波倒置深度与心尖肥厚程度无明显相关。 相似文献
16.
17.
Oellers P Omer S Makosch G Kumar R Rashid HU Navarijo JP Ott DA 《Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital》2010,37(5):576-578
Transaortic myectomy is the standard treatment for symptomatic patients with hypertrophic obstructive cardiomyopathy that proves to be refractive to medical therapy. We encountered a case that required a modified surgical approach to relieve a left ventricular outflow tract obstruction that could not be adequately resected through the aortic annulus because of poor exposure of the ventricular septum. Persistent high gradients after the 1st operation necessitated a 2nd operation. We used a novel approach via the left ventricular apex that enabled us to resect a large amount of obstructive tissue under direct vision and thereby to relieve the left ventricular outflow tract obstruction. 相似文献
18.
P V Fragola C Autore G Ruscitti A Picelli M Borzi D Cannata M Sangiorgi 《Giornale italiano di cardiologia》1988,18(1):52-54
Eighty-nine first-degree relatives of 22 patients with an established diagnosis of hypertrophic cardiomyopathy underwent electrocardiographic and echocardiographic screening. Scalar electrocardiogram was abnormal in 30/89 (33.7%) relatives. Of these thirty, eleven had definite evidence of hypertrophic cardiomyopathy at echo; one had borderline hypertrophy and was considered neither affected nor unaffected; four had questionable signs of hypertrophy. The remaining 14 relatives had normal echo-cardiograms. Fifty-nine relatives (66.3%) had normal electrocardiograms; at echo 3 were considered to have borderline hypertrophy, 16 had questionable signs of hypertrophy and 40 were normal. In relatives of patients with hypertrophic cardiomyopathy an abnormal electrocardiogram may reflect different morphologic conditions: a real hypertrophic cardiomyopathy or a myocardial hypertrophy of uncertain significance. Furthermore, in these categories of subjects, an abnormal electrocardiogram with normal echo must be considered with caution. 相似文献
19.
Yufu K Takahashi N Ooie T Shigematsu S Hara M Sako H Miyamoto S Hadama T Tsuchiya T Honda T Yoshimatsu H Saikawa T 《Internal medicine (Tokyo, Japan)》2004,43(4):295-299
We report a case of severe hypertrophic obstructive cardiomyopahy (HOCM) that was markedly improved by left ventricular (LV) apex epicardial pacing. A 55-year-old woman with HOCM had suffered from dyspnea. Cardiac catheter examination showed a resting pressure gradient across the LV outflow tract of 198 mmHg despite combined medication. During the examination, right dual-chamber pacing could not sufficiently reduce the pressure gradient. Therefore, we treated the patient with LV apex epicardial pacing. The procedure decreased the pressure gradient to 10 mmHg. Clinical symptoms were markedly improved. LV apex epicardial pacing may be an alternative therapy for patients with HOCM who are refractory to other medical treatment. 相似文献